April 2020

AIHC Monthly Newsletter

View Archived Monthly Newsletter:


 March 2020

February 2020


In This Newsletter




Tracking Daily COVID-19 Cases & Current Events

Click Here for the CDC website for “COVID-19: U.S. at a Glance” Statistics.  Information is updated at noon daily by the Centers for Disease Control.  Click Here for the World Map.

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Coronavirus Waivers

Using section 1135 of the Social Security Act (SSA), the government can temporarily modify or waive certain Medicare, Medicaid, CHIP, or HIPAA requirements, called 1135 waivers.  

There are different kinds of 1135 waivers, including Medicare blanket waivers.  When there's an emergency, sections 1135 or 1812(f) of the SSA allow us to issue blanket waivers to help beneficiaries access care.  When a blanket waiver's issued, providers don't have to apply for an individual 1135 waiver. Click Here for more information about the Coronavirus Waivers. 

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MIPS and COVID-19 Relief for Clinicians, Providers, Hospitals and Facilities

The 2019 MIPS data submission deadline will be extended by 30 days to April 30, 2020.  

CMS is implementing additional extreme and uncontrollable circumstances policy exceptions and extensions for upcoming quality measure reporting and data submission deadlines for the Quality Reporting Programs.  

For those programs with data submission deadlines in April and May 2020, submission of those data will be optional based on the facility’s choice to report. 

No data reflecting services provided January 1, 2020-June 30, 2020 will be used in CMS’s calculations for the Medicare quality reporting and value-based purchasing programs in order to reduce providers’ data collection and reporting burden as they are responding to the COVID-19 pandemic.  


For Quality Payment Program questions you can contact 1-866-288-8292, Monday through Friday, 8:00 AM-8:00 PM ET or by e-mail at: QPP@cms.hhs.go or go to the CMS  Current Emergencies page.

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Civil Rights Laws and HIPAA Flexibilities During the COVID-19 Emergency


On Saturday, March 28, 2020 the Office for Civil Rights (OCR) issued a notice to remind covered entities of obligations not to discriminate.  OCR enforces the Americans with Disabilities Act, Section 504 of the Rehabilitation Act, the Age Discrimination Act, and Section 1557 of the Affordable Care Act which prohibits discrimination in HHS funded health programs or activities.

OCR is particularly focused on ensuring that covered entities do not unlawfully discriminate against people with disabilities when making decisions about their treatment during the COVID-19 health care emergency.  The notice serves as a reminder to health care covered entities of unprecedented HIPAA flexibilities recently made available by OCR in response to the COVID-19 emergency concerning:

For general information regarding COVID-19, please see: https://www.coronavirus.gov/ 

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COVID-19 Emergency & Federal Financial Relief for Medicare Providers


There has been significant disruption to the healthcare industry, with providers being asked to delay non-essential surgeries and procedures, other healthcare staff unable to work due to childcare demands, and disruption to billing, among the challenges related to the pandemic.

In response, the Centers for Medicare & Medicaid Services (CMS) is announcing an expansion of its accelerated and advance payment program for Medicare participating health care providers and suppliers, to ensure they have the resources needed to combat the 2019 Novel Coronavirus (COVID-19). This program expansion, which includes changes from the recently enacted Coronavirus Aid, Relief, and Economic Security (CARES) Act, is one way that CMS is working to lessen the financial hardships of providers facing extraordinary challenges related to the COVID-19 pandemic.

Accelerated and advance Medicare payments provide emergency funding and address cash flow issues based on historical payments when there is disruption in claims submission and/or claims processing. CMS is expanding the program for all Medicare providers throughout the country during the public health emergency related to COVID-19.  

The payments can be requested by hospitals, doctors, durable medical equipment suppliers and other Medicare Part A and Part B providers and suppliers.  To qualify for accelerated or advance payments, the provider or supplier must:

  • Have billed Medicare for claims within 180 days immediately prior to the date of signature on the provider’s/ supplier’s request form,

  • Not be in bankruptcy,

  • Not be under active medical review or program integrity investigation, and

  • Not have any outstanding delinquent Medicare overpayments.

Medicare will start accepting and processing the Accelerated/Advance Payment Requests immediately. CMS anticipates that the payments will be issued within seven days of the provider’s request.   


Step-by-Step Guide – How to Request Accelerated or Advance Payment

An informational fact sheet on the accelerated/advance payment process and how to submit a request Click Here.

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Medicare: Dates of Service Update Regarding Pneumococcal Pneumonia Vaccination (PPV) Codes 90670, 90732


Beginning April 13, 2020, for both PPV Healthcare Common Procedural Coding System (HCPCS) codes (90670 and 90732), CMS will return for all FFS beneficiary eligibility transactions Dates of Service (DOS) and institutional National Provider Identifier (NPI) for Part A or rendering NPI for Part B, depending on the provider type who administered the service; instead of next eligibility dates, as previously returned. During the transition to return PPV dates of service vs next eligible dates, Medicare FFS will not return any PPV data from March 14, 2020, through April 12, 2020.

The CMS Fact Sheet MM11335 has been revised related to a provider determining if the beneficiary already received either or both vaccines and when.  

Medicare FFS eligibility transactions will give providers more PPV details for a Beneficiary, including up to 10 occurrences of historical PPV HCPCS codes, NPI, and DOS for each beneficiary. If providers don’t see a DOS/NPI for a particular beneficiary, Medicare FFS didn’t pay a claim for a PPV service; providers may administer the vaccine as medically appropriate and bill for the service.  Click Here to download the Revised Fact Sheet.

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Online Training with Option to Certify – Expand Your Expertise


Training is provided by the American Institute of Healthcare Compliance, Inc. a 501(c)(3) Non-Profit Healthcare Organization.  All courses are online with no classes to attend (on-demand) with access to a qualified instructor if/when you need help.

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Upcoming Live Training Events

Soon it will be safe to travel – plan now for these live events in Fall of 2020

  • HIPAA – September 2-3, 2020 (Las Vegas)

  • Medicare Cost Reporting – September 23-24, 2020 (Nashville)

  • Corporate Compliance – November 11-12, 2020 (Tampa)

Click Here for information on all 2020 live events

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Mastering ICD-10-CM 2020

*Option to Certify as an ICDCT-CM Trainer

Price: $625 (AIHC Member Price: $595)
Spring Fling - Pay $495 through May 1st, 2020

CDI for the Medical Office

*Option to Certify and Earn CMDP Credential

Price: $625 (AIHC Member Price: $595)
Spring Fling - Pay $495 through May 1st, 2020
To Code -or- Not to Code!
2020 Diagnosis Coding Course 

Clinical Documentation Improvement

Hospital Inpatient CEU Course

Physician Office Coding Course

Psychiatric Coding & Documentation Compliance


Veterans & Active Military receive a Free membership 

* Click here for details! 

Unemployed or time for a change?  Get the “edge” on the competition.

  Find Jobs!  Post Jobs!  


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